A number of neuro-ophthalmic presentations may suggest the patient is suffering from an undetected case of obstructive sleep apnea (OSA), according to a new report published in the October Journal of Neuro-Ophthalmology. 

The Australia-based researchers examined a variety of research databases hunting for the associations between systemic and ophthalmic conditions. They found evidence of an independent association between OSA and both hypertension and Type 2 diabetes. Additionally, they found that the retinopathy associated with each of those diseases is associated with OSA, suggesting that patients with diabetic retinopathy or retinopathy of hypertension could also be experiencing OSA without even realizing it. Evidence also suggests a link between OSA and two other ocular conditions: central serous retinopathy and nonarteritic anterior ischemic optic neuropathy.

Additionally, the researchers uncovered details about the connections, such as evidence showing that OSA severity correlates with the degree of hypertension in patients with both conditions. 

The study was not able to conclusively connect Type 2 diabetes itself to OSA, due to the diseases’ relationships with obesity. Other conditions, such as retinal vein occlusion, had a slight connection to OSA. 

“Far from being a single system disorder, it is being increasingly recognized as having systemic sequelae, including the eye and central nervous system. Larger scale studies are needed to investigate the role of OSA as a risk factor for diseases seen in neuro-ophthalmology,” the researchers concluded in their report, also suggesting that their work shows eye care practitioners “may be uniquely positioned to identify at-risk patients” for OSA based on their ocular presentations.

Wong B, Fraser C. Obstructive sleep apnea in neuro-ophthalmology. J Neuro-Ophthalmol. journals.lww.com/jneuro-ophthalmology/Abstract/publishahead/ Obstructive_Sleep_Apnea_in_Neuro_Ophthalmology.99205.aspx. October 8, 2018. [ePub ahead of print].